Commercial computer programs for nursing homes concentrate on financial aspects and have only rudimentary functions which might assist in the areas of nursing management nad quality assurance. Utilizing a relational data base (dBMAN) we have successfully case mix reimbursement system for nursing homes. The RUG's capture significant clinical information through a standardized Patient Review Instrument (PRI). Because the RUG's were developed for reimbursement purposes, the PRI lacks clinical information which would aid nursing management. In phase one of this proposal, we propose the following specific aims: (1) To expand the RUG-II data by addition of key fields to enhance its capabilities to capture relevant patient oriented data. (2) To focus on changes in patient mobility, and the use of restraints (physical and chemical), as two distinct models to explore computer assisted quality assurance. (3) To establish the relevance of computer assisted quality assurance in nursing homes.